Hypothyroidism in infants and children

Thyroid gland problems are occasionally seen in children but the condition, also known as hypothyroidism in children is not common. About one in four thousand infants are found to have the condition. This disease can result in a slow down of the child’s mental and physical development if not treated. Thyroid gland disease affects newborn as well as older children and treatment is the same for any age.

Some common symptoms of hypothyroidism:

• Fatigue
• Weight Gain
• Muscle weakness
• Depression
• Slow speech
• Dry skin
• Brittle or dry hair
• Constipation
• Muscular cramps
• Poor mental and school performance
• Slow development of teeth
• Delay in puberty]
• Goiter (enlargement of the thyroid gland in front of neck)

There is a fairly common problem of the thyroid gland called Hashimoto’s thyroiditis that is considered to be to blame for many cases of infant hypothyroidism. This may also be called juvenile hypothyroidism and this is thought to be inherited. If a mother had thyroid issues when she was pregnant that was most likely due to her hormones being off balance and this would not be carried down to the baby unless she went untreated. If hypothyroidism went untreated in a pregnant mom this may result in learning and developmental disabilities after her child is born.

A visit to a Pediatric Endocrinologist will help answer many questions regarding hypothyroidism in children.

Children and infants with hypothyroidism

There are several types of hyperthyroidism found in small children or infants that are considered congenital or inherited.

• Congenital Hypothyroidism (CH) is present from birth and by far the most common at ninety percent of total cases found. The thyroid gland itself may be out of place, underdeveloped, or failing to produce hormones.
• A transient form of CH occurs in about ten percent of the cases noted and is temporary or transient. Most likely the mother was treated for Graves’ Disease (hyperthyroidism) while pregnant. This form usually goes away within a few months.
• Lastly there is a form of hypothyroidism in children that is considered to be an acquired disease and this affects mostly older children (more commonly found in girls than boys). This form typically results from an autoimmune thyroid disease like Hashimoto’s disease and is typically found in children of puberty age or younger.

Detecting hypothyroidism disease in children

There is a very common test method that includes checking for thyroid diseases and that is the PKU (phenylketonuria) blood test. That will test for several maladies that affect infants and is done shortly after birth.

As infants typically don’t show an significant symptoms of thyroid disease, they may have it for months without any treatment, making those early tests vital. One method of determining if the infant has hypothyroidism is to x-ray their legs and knee area as the knee will be underdeveloped if there is hypothyroidism in children present. Taking a scan of the thyroid gland, in an infant who displays symptoms of thyroid disease, may determine whether the gland is improperly located, malformed, or even absent. Testing such as above can be done before the baby is sent home.

Explain Hypothyroidism disease to me

You may very well have hypothyroidism and not even know it for a long time. Yet there are symptoms that will be obvious if you examine yourself closely, or preferably, have a checkup in your doctor’s office. Hypothyroidism is a disease of the thyroid gland in which there is not sufficient production of the thyroid hormone.

Some causes of hypothyroidism

Some three percent of the population is affected by this disease, and that can be at any age, from infant on. One of the main causes of this disease is exposure to iodine or a deficiency in iodine.

Hypothyroidism may be the result of postpartum thyroiditis which affects about five percent of mothers within the first year of giving birth. This may be seen as hyperthyroidism (overly active thyroid gland) initially, then as the thyroid gland returns to normal, develops into hypothyroidism.

Hypothyroidism may also be an inherited trait, known as an autosomal recessive. It may also be caused by the intake of a high amount of iodine.

In many instances, the disease is classified according to its site of origin.

• Primary: has its point of origin with the thyroid gland itself, most commonly resulting from an overabundance of iodine or an autoimmune disease.
• Secondary: the pituitary gland will not be creating sufficient amounts of TSH or thyroid stimulating hormone and so there is not enough thyroxine and triiodothyronine produced. Most likely these symptoms are the result of some damage done to the pituitary gland (most likely causes include radiation, tumor, or surgery).
• Tertiary: The hypothalamus does not produce enough hormones.

Occasionally hypothyroidism may be the result of mood stabilizers which are lithium based and intended to treat a bipolar disorder (manic depression). Another cause may be ADHD or sluggish or inattentive awareness.

Symptoms vary

The symptoms of hypothyroidism vary according to length of time the person has been affected by the disease.

• Early symptoms: include fatigue, depression, goiter, intolerance to cold, poor muscle tone, brittle fingernails and hair, paleness, weight gain, water retention, and constipation.
• Late symptoms: Puffy dry facial skin, hoarse voice and slowed speech, low body temperature, thinness of the outer one third of eyebrows.
• Less commonly seen symptoms: include hair loss, anemia, impaired memory, inattentiveness (brain fog), shortness of breath, irritability, unstable mood swings, decreased libido, and a puffy face along with hands and or feet.

How to diagnose hypothyroidism disease

The most common tests for this disease include measuring the thyroid stimulating hormone (TSH) amount that is produced by the patients pituitary gland. High levels of this hormone show that the thyroid gland is not giving out enough in specific hormones as is necessary. These hormones include thyroxine (T4) and triiodothyronine (T3). Also relevant are testing basal body temperature and anemia testing.

Treatments vary

Hypothyroidism disease is commonly treated with thyroxine (L-T4) and also triiodothyronine (L-T3). There are animal derived as well as synthetic forms of thyroid hormone which are taken daily. A doctor will keep an eye on blood levels to assure the dose is sufficient. Some of the treatment protocols are controversial and can vary from patient to patient. Some will respond better than others as well.

While the thyroid itself is responsible for the improper hormone production that leads to the disorder, the actual cause for the disorder may be manifestation of problems within the pituitary gland, responsible to providing the signals to the thyroid regarding the amounts of each hormone to produce.

As with any production system there are downstream and upstream factors that must be considered when developing a treatment for cases of hypothyroidism. Many manifestations of the disorder arise after damage has occurred to the tissue of the thyroid gland, reducing the capacity of the body to produce thyroid hormones required to regulate and maintain normal cell metabolism.

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The disorder is usually diagnosed via symptomatic analysis and subsequent blood testing, but further testing may be required to derive the exact cause of the hormone levels being deviant from normal. In certain cases the regulatory function of the pituitary gland and the signals it provides to the thyroid are found to be at fault. Rather than being unable to produce the required thyroid hormones through a lack of thyroid tissue, the thyroid gland may instead be receiving inappropriate signals and inputs from the pituitary gland.

When the disorder is a result of incorrect functioning of the mechanisms that maintain the correct functioning of the thyroid, rather than a malfunctioning of the thyroid itself, the disorder is deemed to be caused by secondary factors. Due to the complex nature of pituitary function, care must be taken when establishing treatment regimes.

The upshot of pituitary gland function being flawed over a primary thyroid disorder is that the thyroid itself can often be perfectly healthy, just running on incorrect inputs. Once these inputs are corrected, the patient can return to normal thyroid function and experience minimal discomfort. This is a much cheerier scenario than that of the primary sufferer, who may no longer have a functional thyroid.

The level of Thyroid stimulating hormone (TSH) provided by the pituitary gland controls the hormone production of the thyroid gland itself. If the level of TSH provided is not suitably adjusted to the body’s needs, there will commonly arise hypothyroidism.

Symptoms to note are puffy skin, drowsiness, weight gain and other symptoms that are also common to Hashimoto’s thyroiditis, a primary thyroid disorder, caused by damage to thyroid tissue resulting autoimmune response and inflammation of the thyroid tissue.

When the pituitary gland itself is functional, but is receiving improper signals that entail its own outputs are not correct for the thyroid gland to maintain required hormone levels, the condition is deemed to be caused by tertiary factors. This can often be a result of incorrect signaling from the hypothalamus.

Sufferers of hypothyroidism should make sure that the treatment they are receiving is appropriate for their condition, in order that they are not receiving drugs without necessity. By understanding the relationship between the body’s complex biological systems and the ways in which each system will feedback into the others, a sufferer can make their day and life better.